Offer summary

Qualifications:

Bachelor's degree preferred or five years of related experience in regulatory submissions, project management, or market research analysis., At least 2 years of project management experience is required., 1 year of strategic planning experience is required., Intermediate proficiency in Excel, including Pivot tables, SQL, and Visual Basic is preferred..

Key responsabilities:

Lead the completion of templates and binders for Qualified Health Plan (QHP) submissions.

Ensure alignment of business processes with state and federal regulatory requirements.

Collaborate with internal stakeholders and assess impacts of program changes related to QHP requests.

Assist with market analysis, competitive research, and business support activities as assigned.

Job description

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is hiring a Qualified Health Plan (QHP) & Business Support Manager- Remote!

Status: Full-time, permanent position (40 hours)

Work hours: 8am to 5pm EST, M-F

Remote opportunities available in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming!

Job responsibilities:

The Qualified Health Plan (QHP) & Business Support Manager, leads and conducts the completion of templates and binders for Qualified Health Plan (QHP) submission. This role ensures alignment of business processes with state and federal regulatory requirements, while collaborating with internal stakeholders and SMEs, and coordinating and assessing the impacts of program changes tied to QHP requests from the state and federal regulators. Creates a thorough understanding of contractual, regulatory and timing requirements for QHP products. The QHP & Business Support Manager also assists with and/or leads market analysis, competitive research, product/benefit and business support activities, as assigned.

Education:

Five years or more related experience supporting responses to regulatory submission requirements, project management and/or market research analysis is acceptable in lieu of degree.
BLD - Bachelor's Level Degree preferred

Certification/Licensure:

None required

Experience:

Project Management- 2 years experience REQUIRED
Strategic Planning- 1 year experience REQUIRED
Market Analysis- 2 years experience REQUIRED
Intermediate proficiency in Excel (Pivot tables, SQL and Visual Basic) preferred
Health Plan experience preferred
Relevant in experience in Compliance/Audit/Regulatory and Operations (Enrollment, Claims) preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-76580

#Monster

Talroo – Health Plan

Keywords: Managed Care, MCO, Healthcare, Health Plan, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming, Individual, Family Health Plans, Commercial, Exchange, Qualified Health Plan, Business Support, Project Manager, Compliance, Audit, Regulatory, Operations, Enrollment, Claims, Excel

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$69,742.40-$116,251.20Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Benefits: Caring For Your Family and Your Career

• Medical, Dental, Vision plans

• Adoption, Fertility and Surrogacy Reimbursement up to $10,000

• Paid Time Off and Sick Leave

• Paid Parental & Family Caregiver Leave

• Emergency Backup Care

• Long-Term, Short-Term Disability, and Critical Illness plans

• Life Insurance

• 401k/403B with Employer Match

• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education

• Student Debt Pay Down – $10,000

• Reimbursement for certifications and free access to complete CEUs and professional development

•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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